Physical Activity Plan
Too lkit
A guide to creating a Physical
activity Plan for your Community
Acknowledgements
Collaborators
We would like to thank the following people for their work on this project, including development and
review:
•
•
•
•
•
Cheryl Valko, Program Manager, Washington University in St. Louis
Alicia Manteiga, Research Assistant, Washington University in St. Louis
Amy Eyler, Physical Activity Policy Research Network, Washington University in St. Louis
Linda Scovern, Nutrition and Physical Activity Coordinator, Ohio Department of Health
Michele Scanze, Active Living Specialist, Arizona Department of Health Services
Funding
This study was funded by the Centers for Disease Control and Prevention (CDC) Cooperative Agreement
Number U48/DP001903 from the CDC, Prevention Research Centers Program, Special Interest Project
9-09, and The Physical Activity Policy Research Network. The findings and conclusions in this report do not
necessarily represent the official position of the Centers for Disease Control and Prevention.
Contact Information
Any suggestions or feedback are warmly welcomed, and can be directed to Amy Eyler at the Physical Activity
Policy Research Network at: [email protected]
Credits
Photos courtesy of True Colors, St. Louis University (cover page, top left), pedbikeimages.org/Dan Burden
(cover page, top middle, top right, bottom middle), istockphoto.com (cover page, bottom left), James D.
Schwartz on Flickr (cover page, bottom left), Josie Holford on Flickr (page 4), istockphoto.com (page 7),
pedbikeimages.org/Dan Burden (page 8), Michigan Municipal League on Flickr (page 10), sfbike on flickr
(page 11), Mecklenburg County on Flickr (page 17), and True Colors, St. Louis University (page 19).
Last updated October 2013.
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Table of Contents
Overview 4
Introduction
5
Step 1: Build a Coalition
6
Step 2: Conduct a Community Assessment
8
Step 3: Develop Goals and Objectives
12
Step 4: Select Intervention Strategies
16
Step 5: Create an Evaluation Plan
20
Step 6: Write the Plan
25
Resources26
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3
Overview
Why Promote Physical Activity?
Non-communicable diseases attributed to physical inactivity are accountable for five million deaths
annually. 1 The decision to be physically active depends on both a person’s motivation and ability to be
active. Businesses, schools, health care centers, city planners, politicians, volunteer organizations and health
care professionals all have a responsibility to help create environments in which people can safely choose to
be physically active.
What is the Purpose of this Toolkit?
This toolkit outlines the components of a physical activity (PA) plan. Each section contains resources and
links to dig deeper into the various parts of the plan. This allows you to tailor the process to best fit your
needs. For example, if you are an expert in writing SMART objectives, but lack expertise in evaluation,
you may want to spend more time exploring the links in Part 5: Create an Evaluation Plan. This toolkit will
streamline the process of creating a physical activity plan and help to outline your community, city, or state’s
commitment to increasing physical activity levels in your area. Once you have completed all of the steps
in the toolkit, we have provided a Physical Activity Plan Template available in Microsoft Word, which can be
edited and tailored to fit your community’s needs. We hope that this will save you valuable time and effort.
Who Will Benefit from using this Toolkit?
This toolkit will directly benefit anyone interested in creating a physical activity plan for their state,
community or area, including physical activity practitioners, community leaders, and anyone interested in
organizing an effort to get people moving.
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Introduction
In May of 2010, the National Physical Activity Plan was launched.2 The Plan includes a set of policies,
programs and initiatives which aim to increase the physical activity of Americans.
Though many states have obesity or wellness plans that include some physical activity focused strategies,
at this time, only two states have created a stand-alone physical activity plan - West Virginia and Texas.3,4
Because physical activity plans are important for providing strategic direction for states, cities, and
communities to rally around physical activity goals, the Physical Activity Policy Research Network has been
asked to compile a guide to facilitate the creation of such a plan.
This guide goes through the six steps of physical activity plan formation, and can be tailored to create plans
targeted for states, cities, or communities.
The six steps to create a physical activity plan include the following:
Step 1. Build a coalition
Step 2. Conduct a community assessment
Step 3. Develop goals and objectives
Step 4. Select evidence-based intervention strategies
Step 5. Create an evaluation plan
Step 6. Write the plan
The first 5 sections contains links to resources and helpful tips to help facilitate the initial steps in creating
a plan. The final section includes a template (offered as a separate, editable Microsoft Word document); it is
our hope that it reduces resources needed for the creation of your plan.
Step
1
Build a
Coalition
Step
2
Conduct a
Community
Assessment
Step
3
Develop
Goals and
Objectives
Step
4
Select
Intervention
Strategies
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Step
5
Create an
Evaluation
Plan
Step
6
Write the
Plan
Physical Activity Plan Toolkit
Physical
Activity
Plan
5
Step 1:
Build a Coalition
Introduction
B
efore the creation of a comprehensive and realistic physical activity plan, it is important to bring
together key stakeholders to rally around the common goal of creating change in the community or
state. Therefore, the first step is to build a physical activity coalition if one does not already exist. A coalition
should contain representatives from diverse backgrounds and multiple areas of expertise and influence.
Unfortunately, of all current, state-level physical activity, nutrition, and obesity plans in the country, fewer
than half include representatives from the food and beverage industry, land use and community design,
faith based organizations, elected officials, and the media. 5 These types of collaborations can be influential
in mobilizing action and creating a foundation for change.
There is extensive literature available on how to develop a coalition, and we have provided links to a
selection of them below.
The Basics of Building a Coalition
Developing Effective Coalitions: An Eight-Step Guide6
Prevention Institute, a national non-profit with a focus on community health through preventive
interventions, outlines a step-by-step process to build an effective coalition.
http://www.preventioninstitute.org/index.php?option=com_jlibrary&view=article&id=104&Itemid=127
The Community Tool Box: Creating and Maintaining Coalitions and Partnerships7
The Community Tool Box strives to promote community health by connecting people, ideas and resources.
This resource is a good complement to the Eight-Step Guide, and includes in-depth information on topics
such as:
•
Finding a common purpose
•
Coalition membership
•
Vision and mission development
•
Identifying and overcoming barriers
•
Maintaining momentum
http://ctb.ku.edu/en/creating-and-maintaining-partnerships#.
Ul1vT1AqjwE
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Communities Putting Prevention to Work: Resource Center
National Physical Activity
Plan Alliance- Vision and
Mission Statement10
•
•
•
•
•
The following is the vision and
mission statement from the
National Physical Activity Plan
Alliance. Your coalition may
want to refer to it for use as an
example.
8
The CDC provides five coalition building guides, each with a different
focus, including:
What to do prior to coalition building
Tips for coalition formation
Tips for the implementation stage
Tips for the maintenance stage
Tips for coalition institutionalization
All of these guides can be accessed from the following web page:
http://www.cdc.gov/CommunitiesPuttingPreventiontoWork/resources/
foundational_skills.htm
Mission and Vision
Once your coalition has been formed, it needs to develop a mission
and vision. The vision of your coalition should outline where your
coalition wants to be in the future. Your mission should state the
purpose of your coalition. Checkout the National Physical Activity
Plan’s mission and vision in the sidebar to the right.
The Community Tool Box
Proclaiming Your Dream: Developing Vision and Mission
Statements9
This tool provides four different guides:
•
•
•
•
What is a vision statement?
What is a mission statement?
Why should you create a vision and mission statement?
How do you create a vision and mission statement?
Vision
All Americans are physically
active and live, work, and play in
environments that facilitate regular
physical activity.
Mission
Develop a National Plan for
Physical Activity that produces a
marked and progressive increase in
the percentage of Americans who
meet physical activity guidelines
throughout life.
http://www.physicalactivityplan.
org/history/index.php
http://ctb.ku.edu/en/table-of-contents/structure/strategic-planning/
vision-mission-statements/main
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Step 2:
Conduct a Community Assessment
Introduction
A
fter the formation of a coalition, an assessment of the target
population’s current demographic, health and physical activity
status is imperative. The community assessment will help the coalition
to prioritize intervention strategies and manage available resources.
Recommended data to gather includes:
• Subpopulation most likely to be physically active
• Subpopulation at the highest risk for physical inactivity
• Distribution of recreational resources, such as parks and
community centers; and walkability of areas
• Policies that hinder or support PA with a focus on the built
environment, the school and the work place setting
This step looks at several resources available to PA coalitions. These
resources are organized into complementary assessment areas:
physical activity levels, demographics, community participation and
built environment.
Community Resources Assessment
Strengths, Weaknesses, Opportunities, Threats (SWOT)
Community assessment includes determining local physical activity
resources, needs and barriers, looking at existing data, and using
existing tools to collect necessary data. In a strengths, weaknesses,
opportunities and threats (commonly referred to as SWOT) analysis,
internal strengths and weaknesses are presented with the external
forces of opportunities and threats. A SWOT can be performed by
coalition members and complemented by community input. The
Community Tool Box offers the following template as well as detailed
instructions at:11
http://ctb.ku.edu/en/table-of-contents/assessment/assessingcommunity-needs-and-resources/swot-analysis/main#.Ul1ybVAqjwE
INTERNAL
Strengths
EXTERNAL
Weaknesses
Opportunities
Threats
Source: The Community Tool Box 11
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Physical Activity and Demographic Assessment
Behavioral Risk Factor
Surveillance System
BRFSS is the world’s largest on-going
telephone health survey system. Their
website provides statewide information on physical activity behavior,
including information on: adults and children who participate in 150
minutes or more of aerobic physical activity per week; adults and
children who participate in muscle strengthening exercise more than
twice a week; and those who meet recommended physical activity
guidelines overall for aerobic and muscle strengthening. Results can be
stratified according to age, gender, race, income and
education. 12
http://apps.nccd.cdc.gov/brfss/index.asp
Youth Risk Behavior Surveillance System
YRBSS monitors six types of health-related
behaviors in 9th-12th grade students in the US. One
of these measures is inadequate physical activity.13
http://www.cdc.gov/healthyyouth/yrbs/index.htm
Community Health Needs Assessment
The Community Health Needs Assessment (CHNA) provides users with
area demographics and performance indicators associated with The
Community Guide, Healthy People 2020, and other sources. CHNA
was designed to save health departments (as well as other agencies)
resources and time by facilitating the compilation of baseline data.14
http://www.chna.org/About.aspx
Community Spotlight
Arizona’s State Specific
Surveillance
Check to see if your area has
existing measures of collecting
baseline physical activity data. For
example, The Arizona Nutrition
and Physical Activity State Plan
uses data from their Arizona
School Health Education Policy
(SHEP). SHEP is a survey sent
annually to school principals
and lead health educators. The
survey provides information
concerning “education curricula,
programs, policies and framework
necessary for the implementation
of education courses, and
professional preparation of health
educators to assess the status of
school health education at the
middle/junior high and senior
high school levels statewide.” 17
http://physicalactivityplan.org/
resources/PA-Plans/ArizonaPA.pdf
The Diabetes Interactive Atlases
The Diabetes Interactive Atlases provide county-level, leisure-time
physical inactivity prevalence for all states.15
http://www.cdc.gov/diabetes/atlas/countydata/County_
EXCELstatelistLTPIA.html
American Community Survey
The American Community Survey (ACS) provides information about
population demographics. ACS is an ongoing statistical survey that
samples a representative percent of the population annually, providing
information on age and sex, ancestry, disability, work commute,
education, employment, family, health insurance, income and earnings,
language, origins, population change, poverty, race and ethnicity, and
veterans.16
http://www.census.gov/acs/www/library/
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Community Participatory Assessment
Champions for Change: Physical Activity Community Assessment
This short assessment aims to help community members determine what physical activity opportunities are
available and accessible.18
http://www.cachampionsforchange.cdph.ca.gov/en/docs/OurCommunity/HowTo/HandPAAssessment.pdf
Complete Streets Advocacy Toolkit
The assessment developed by the Complete Streets for North County Communities, Michigan. The link is
to a toolkit for advocates focusing on the built environment. Pages 8-9 of the toolkit provide a user-friendly
complete streets assessment, and page 10 includes a street assessment.19
http://www.mihealthtools.org/mihc/documents/NorthCountryCommunitiesCompleteStreetsGuide.pdf
Built environment Assessment
Walkability Checklist
How walkable is your community? The Walkability Checklist can help you find out. It includes questions
to answer, in both English and Spanish, as your explore the streets in your community. In addition this tool
gives helpful suggestions to improve walkability. 20
http://www.nhtsa.gov/Driving+Safety/Pedestrians/Walkability+Checklist
Walk Score
Walk Score is a great online tool designed to objectively assess the walkability of an area by analyzing
surrounding features, resulting in a score between 0-100 (100 being the most walkable, or “Walker’s
Paradise”). Walk Score also allows you to view the bikeability of select cities. 21
http://www.walkscore.com
Bikeability Checklist
The Bikeability Checklist helps you determine the bikeability of an area by answering a series of questions
about safety, surfaces, intersections and more. Once you determine your bikeability score, you can view the
suggested improvements and actions steps contained in the tool. 22
http://www.nhtsa.gov/people/injury/pedbimot/bike/bikeability/
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Community Spotlight
Participatory Assessment
Web-based Brainstorming, West Virginia Physical Activity Plan
Plan developers delivered a webinar on June 22, 2011, to inform potential contributors about the WV
Physical Activity Plan and to invite their contribution regarding the brainstorming of ideas. The webinar
included an overview of the National Physical Activity Plan, a summary of the WV plan development
process to date, and a request for their participation in brainstorming as the next important step. The
primary intent of brainstorming was to produce as many ideas or statements as possible in response to
the following prompt:
One specific thing that needs to happen to
increase or promote physical activity in West
Virginia is…
The brainstorming phase included 154 individuals representing all societal sectors and geographic
regions within WV. The participants generated a total of 240 initial ideas or statements that were later
systematically reduced by plan developers to eliminate redundancy. For more information on how they
conducted this participatory survey, visit their website.23
http://wvphysicalactivity.org/?pid=4
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Step 3:
Develop Goals and Objectives
Introduction
O
nce the coalition has completed the community assessment, it is
appropriate to establish goals and objectives which are aligned
with both the mission and vision of the coalition, and also tailored
towards the characteristics of the population and assessment results.
This section takes a look at goals and objectives, explaining what
they are, and then goes in-depth into the process of writing different
types of objectives. The physical activity (PA) plan should include both
process and outcome objectives, and also short, medium, and longterm objectives in order to measure progress and modify programming
as needed. All well-written objectives should be SMART (Specific,
Measurable, Attainable, Relevant and Time-bound).
Take your time crafting objectives for your PA plan, but remember that
they can be modified if progress is faster or slower than the coalition
anticipates.
Goals
A goal is a statement that explains what the program wishes to
accomplish. It sets the fundamental, long-range direction. Typically,
goals are broad general statements. Texas’s physical activity plan,
Active Texas 2020, provides an example:
“A vision without a plan is
just a dream.
A plan without a vision is
just drudgery.
But a vision with a plan can
change the world.”
Proverb
In the broadest sense, the goal of ACTIVE TEXAS 2020 is to increase physical
activity across the state; more specifically, the goal is to have the majority
of Texans meet the US Guidelines for Physical Activity. 24
https://sph.uth.edu/content/uploads/2012/06/Active-Texas-2020-full.
pdf
Good Goals
This concise, helpful resource from the CDC outlines the two key steps
to writing goals and gives some helpful pointers.
http://www.cdc.gov/healthyyouth/evaluation/pdf/ETAGGcardsV421.
pdf
Tips for Writing Goals and Objectives
This resource from Tulane highlights some important practices for
goal-writing, and identifies important differences between goals and
objectives.
http://tulane.edu/publichealth/mchltp/upload/Tips-for-writing-goalsand-objectives.pdf
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Objectives
Objectives break the goal down into smaller parts that provide
specific, measurable actions by which the goal can be accomplished.
Physical activity plan objectives can be oriented around the target
areas of the National Physical Activity Plan (NPAP). Those areas include:
Business and Industry; Education; Healthcare; Mass Media; Parks,
Recreation, Fitness and Sports; Public Health; Transportation, Land
Use and Community Design; and Volunteer and Non-Profit. For more
information, check out the NPAP’s website.
http://www.physicalactivityplan.org/index.php 25
Process and Outcome Objectives
“You’ve got to think about
the ‘big things’ while doing
small things so that all the
small things go in the right
direction.”
Alvin Toffler
American Writer
The two general types of objectives are process and outcome. Process
objectives answer the questions of what and who, while outcome
objectives focus on the intended program results. For clear, concise
information on process and outcome objectives, the CDC Evaluation
Research Team offers a worksheet available at:26
http://www.cdc.gov/healthyyouth/evaluation/pdf/brief3b.pdf
Both the Iowans Fit for Life and Delaware Partners to Promote Healthy
Eating and Active Living state plans provide examples of PA-oriented
process and outcome objectives, on pages 35 and 23, respectively.27,28
http://www.idph.state.ia.us/iowansfitforlife/common/pdf/activity_plan.
pdf
http://dhss.delaware.gov/dhss/dph/dpc/files/pano_comp_plan-09.pdf
Short-Term, Intermediate, Long-Term Objectives
Objectives should also touch on short-term, intermediate and longterm time periods.
• Short-Term Objectives specify the short-term results that
need to occur to bring about sustainable long-term changes.
For example, changes in knowledge need to take place first
in order to bring about long-term changes in physical activity
behavior. As a general rule, the time frame for short-term
objectives can be as short as 2–3 months to around 1 year.
• Intermediate Objectives typically result from and follow
short-term outcomes and often look ahead 1 -2 years.
Intermediate objectives act as stepping stones and can help
maintain motivation to achieve the long-term objectives.
• Long-term Objectives specify the outcomes or changes
needed to achieve the overall goal, such as an increase in the
number of children walking to school or changes in health
status resulting from the implementation of a public policy or
environmental changes supporting physical activity. The time
frame for the achievement of long-term objectives is usually
2–5 years.
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Community Spotlight
The Ohio Obesity Prevention Plan gives examples of objectives divided in a similar manner (they use
the terms “immediate, short-term and long-term”), which can be found on pages 14, 16 and 17.26 A few
examples from the Ohio Obesity Prevention Plan are shown below.
Short-term
• By Dec. 31, 2009, identify additional inter-agency partnerships for opportunities to promote
progress toward the plan.
Intermediate
• By Dec. 31, 2011, identify best practices and develop resources for employers to improve
physical activity at worksites, including worksite facilities (i.e. showers on site), work day
flexibility and incentives for physical activity, policies and activities.
Long-term
• By Dec. 31, 2014, develop and make recommendations to state government related to policy
and funding for communities that limit sprawl and reward comprehensive planning efforts that
support improved built environments and encourage pedestrian-friendly communities.
To see all of the objectives from Ohio’s plan, click on the link below and scroll to pages 14 -18.29
http://www.healthyohioprogram.org/~/media/HealthyOhio/ASSETS/Files/obesity/
ohioobesitypreventionplan.ashx
SMART Objectives
A well-written objective will address who is going to do what, when, and to what extent. A different way to
look at objective writing is to ensure that they are SMART: Specific, Measurable, Attainable, Relevant, and
Time-bound. For more information on writing SMART objectives, see the CDC Program Evaluation Guide:
Writing SMART Objectives. It is “intended to help states develop realistic and measurable objectives.” The
SMART section begins on the third page.30
http://www.cdc.gov/dhdsp/programs/nhdsp_program/evaluation_guides/smart_objectives.htm
For more examples of SMART objectives from state plans, see the following:
Kentucky Nutrition and Physical Activity State Plan 2005, pgs. 44-45 31
http://fitky.org/
Moving South Carolina Towards a Healthy Weight, Appendices pg. 2 32
http://www.scdhec.gov/health/chcdp/obesity/docs/StatePlanComplete.pdf
Georgia’s Nutrition & Physical Activity Plan, pg. 2933
http://beproactivefoundation.org/media/6a9a857bc6e14cbdffff8020ffffd523.pdf
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SMAR T
Specific
Measurable
What exactly are Is it quantifiable
we going to do for and can we
whom?
measure it?
Attainable
Can we get it
done in the
proposed time
frame with the
resources and
support we have
available?
Relevant
Time-bound
Will this objective When will this
have an effect on objective be
the desired goal accomplished?
or strategy?
Additional Resources
Tip Sheet: Writing Measurable Objectives
This tip sheet from the Victoria Department of Health gives specific advice on useful vocabulary for creating
each type of objective.34
http://www.health.vic.gov.au/regions/southern/downloads/Tip-sheet-writing-measurable-objectives.pdf
Guidelines for School and Community Programs to Promote Lifelong Physical Activity Among
Young People
Published in 1997, these guidelines include many specific physical activity objectives (for examples, see
page 5).35
http://www.cdc.gov/mmwr/PDF/rr/rr4606.pdf
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Step 4:
Select Intervention Strategies
Introduction
A
fter the objectives have been completed, the next step is to select
intervention strategies to guide the actions of the physical activity
coalition. Intervention strategies are based on SMART objectives; successfully implementing strategies and associated projects will lead to
the completion of objectives, and ultimately help the coalition to reach
their major goals.
Intervention strategies should be evidence-based and tailored to the
ethnic and cultural groups in your community.
As mentioned in step 3, the National Physical Activity Plan includes
intervention strategies that can be classified into eight sectors:
• Business and Industry
• Education
• Health Care
• Mass Media
• Parks, Recreation, Fitness and Sports
• Public Health
• Transportation, Land Use, and Community Design
• Volunteer and Non-Profit36
For more information, visit the National Physical Activity Plan Website:
http://www.physicalactivityplan.org/theplan.php
The following pages include several successful intervention strategies
that can be used as a reference or as inspiration.
Evidence-Based Intervention Approaches
The Community Guide to Preventive Services (The
Community Guide)
The Community Guide provides systematic reviews of physical activity
interventions in the following areas:
1. Campaigns and Informal Approaches
2. Behavioral and Social Approaches
3. Environmental and Policy Approaches
Spotlight on
Education, Parks, and
Transportation
Safe Routes to School
In summer 2007, the city of
Columbia, MO received a $15,725
Safe Routes to School (SRTS)
grant through the Missouri
Department of Transportation.
Parents, teachers and residents
attended a community meeting to
determine how to take advantage
of the underutilized community
park located behind the school.
The attendees concluded that if
the school officials rerouted the
buses to drop off the children at
the park, the children could walk
less than 10 minutes through the
park to reach the school. To ensure
the safety of the children, students
from nearby Columbia College
volunteered to monitor the
children as they walked through
the park to school.
The school is working with the
Department of Transportation
to see the street next to West
Boulevard Elementary become
a one-way street as well as plant
traffic- calming devices.38
Under each approach are specific intervention strategies as well as
information regarding supporting evidence.37
http://thecommunityguide.org/pa/index.html
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Policy Spotlight
Wheeling Walks
This webpage gives information on how the Wheeling Walks
intervention- one which strives for physical activity in older adult
populations- was implemented. It touches on the resources needed,
intended audience, and provides links to studies published regarding
the program.39
http://rtips.cancer.gov/rtips/programDetails.do?programId=234167
Safe Routes to School
This program began in 1997, and has expanded to all 50 states. Their
webpage includes information regarding funding, training, and
programming tools.40
http://www.saferoutesinfo.org/about-us/mission-and-history
National Complete Streets Coalition
This website provides the basics of Complete Streets initiatives, an atlas
of where complete street planning has and is occurring, as well as a
presentation online and resources for further information.41
http://www.smartgrowthamerica.org/complete-streets/completestreets-fundamentals
Complete Streets Act of 2009
Building complete streets
will help address some of the
most pressing issues facing
our country today—climate
change, the obesity epidemic,
air quality, safety, congestion,
and many more by giving
people transportation options
and reducing reliance on cars.
The Complete Streets Act of
2009 requires state and local
transportation planners to
consider the needs of all users—
bicyclists, pedestrians, motorists,
bus riders—when designing
transportation facilities funded
with federal dollars.
On April 24, 2009 Delaware
Governor Markell signed
Executive Order Number Six
requiring the creation of a
Delaware Complete Streets Policy
by September, 2009. This policy
will focus not just on individual
roads, but changing the decisionmaking and design process and
will recognize that all streets are
different and user needs should
be balanced in order to ensure
that the solution will enhance the
community.
Delaware Department of
Transportation
Delaware Partners to Promote
Healthy Eating and Active Living:
Physical Activity, Nutrition and
Obesity Prevention Comprehensive
Plan42
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Industry spotlight: Safeway
In 2005, the grocery giant, Safeway, began Safeway’s Healthy Measures program, an employee wellness program
that was so successful it has gained nationwide attention.
Their program included the following:
•A 17,000 square foot, state-of-the-art fitness center on their corporate campus
•Discounts at national fitness centers
•An online tool that helps employees make the most of their healthcare benefits by making healthcare costs
transparent
•Medical decision support through MedExpert, an independent, medical information company
Of the 5,334 employees who participated, 18,734 pounds were lost, 44% improved their glucose levels, 63%
improved their blood pressure, 47% improved their cholesterol levels and 15% improved their Body Mass Index
(BMI). Safeway, a self-insured employer, has kept their per capita health-care costs flat, while American companies
have seen a 38% increase in healthcare expenditures.43
http://csrsite.safeway.com/people/employees/health-wellness/
Open Streets
Open streets initiatives close streets to cars and open up to nonmotorized vehicles. Over 80 initiatives have been recorded in North
America. Their website provides information covering every aspect of
how to implement an open street program in any state.44
http://openstreetsproject.org/
Interventions on Diet and Physical Activity: What Works
The World Health Organization details international interventions
on diet and physical activity in a summary report and includes the
following categories: policy and environment, mass media, schools,
workplace, community-based interventions, primary health care, older
adults and religious settings. Evidence-based intervention information
is provided. The aim of the interventions is to reduce the risk of noncommunicable diseases.45
http://www.who.int/dietphysicalactivity/whatworks/en/
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HEAT
Health Economic Assessment Tools for walking and cycling
This document can be useful at many stages in the planning process;
community assessment, implementation of strategies, and also
evaluation. It includes planning and interventions to increase the
amount of walking and cycling in a community. According to the
website, the booklet summarizes “the methodology for the economic
assessment of transport infrastructure and policies in relation to
the health effects of walking and cycling; systematic reviews of the
economic and health literature; and guidance on applying the health
economic assessment tools and the principles underlying it.” The guide,
sponsored by the World Health Organization, can be accessed at:46
http://www.heatwalkingcycling.org
Healthcare Spotlight
Behavioral and Social
Approaches to Increase Physical
Activity: Individually-Adapted
Health Behavior Change
Programs
Individually-adapted health
behavior change programs
to increase physical activity
teach behavioral skills to
help participants incorporate
physical activity into their daily
routines. The programs are
tailored to each individual’s
specific interests, preferences,
and readiness for change. A
health-care setting can be ideal
for such a program.
These programs teach
behavioral skills such as:
• Goal-setting and selfmonitoring of progress
toward those goals
• Building social support for
new behaviors
• Behavioral reinforcement
through self-reward and
positive self-talk
• Structured problem solving
to maintain the behavior
change
• Prevention of relapse into
sedentary behavior47
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Step 5:
Create an Evaluation Plan
Introduction
T
he development of an evaluation plan is a crucial element of any intervention- an element which is
commonly overlooked or hastily prepared. The evaluation of the physical activity plan should be created
during the planning phase, prior to implementation. This evaluation should be based off of the plan’s stated
goals and objectives (see step 3). The evaluation will be a tool in assessing whether or not these goals and
objectives have been achieved.
The evaluation plan helps the coalition see the big picture along with the details, so that resources can be
identified early on. This is a fluid document which will change based on budget, resources, objectives and
accomplishments.
The evaluation should address both process and outcome measures. Process evaluation focuses on the
quality and implementation of interventions and activities, whereas outcome evaluation concentrates on
assessing the achievement of selected outcomes of activities and interventions. Outcome evaluation should
be built on process evaluation.
Guides to Program Evaluation
Physical Activity Evaluation Handbook
The Centers for Disease Control and Prevention (CDC) have identified six steps which are pivotal to the
development of an evaluation plan in their Physical Activity Evaluation Handbook.47 This useful document
can be found at: http://www.cdc.gov/nccdphp/dnpa/physical/handbook/pdf/handbook.pdf
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Developing an Effective Evaluation Plan
That framework is taken from a more comprehensive workbook, also published by the CDC. This workbook
is intended for “health program managers, administrators and evaluators.” This tool includes a description of
how to write an effective evaluation plan as well as exercises, worksheets, tools and resources for staff and
stakeholders. It can be accessed at:49
http://www.cdc.gov/obesity/downloads/CDC-Evaluation-Workbook-508.pdf
Evaluation of State Nutrition, Physical Activity, and Obesity Plans
The CDC also has created a technical assistance manual for states to use and offers guidance on evaluation.50
http://www.cdc.gov/obesity/downloads/EvaluationofStateNPAOPlans.pdf
Basic Guide to Program Evaluation
This guide is intended for planning and implementing an evaluation process for for-profit or nonprofit
programs and discusses the various types of evaluations that can be applied to programs (i.e. goals-based,
process-based, outcomes-based).51
http://managementhelp.org/evaluation/program-evaluation-guide.htm
Indicator development
Using Indicators for Program Planning and Evaluation
Outcome indicators are specific, measurable, observable characteristics or changes that will represent
achievement of an outcome. A document which can aid in the development of indicators and their use in
conjunction with a logic model, published by the CDC, can be found at:52
http://www.cdc.gov/dhdsp/programs/nhdsp_program/evaluation_guides/docs/Using_Indicators_
Evaluation_Guide.pdf
Example of an Evaluation Worksheet
Use the example below as a guide to creating and completing your own evaluation worksheet.
Worksite Wellness
Evaluation Questions
Outcome Indicators
Data Collection
1. To what extent have
employers implemented
wellness programs and
interventions?
1. % encouraging
physical activity among
employees
2. % providing physical
activity opportunities
among employees
3. % encouraging
sedentary screen-time
reduction policies
State Employer Survey
paprn.wustl.edu
When to collect/Who is
responsible?
Survey last completed
by [name of agency] in
2010; will be conducted
again in 2015.
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Physical Activity Logic Model Development
Logic Model Development Guide
According to the W.K. Kellogg Foundation, a program logic model is defined as “a picture of how your
organization does its work – the theory and assumptions underlying the program. A program logic model
links outcomes. . .with program activities/processes and the theoretical assumptions/principles of the
program.” Checkout the link below to access the W.K. Kellogg Foundation Logic Model Development Guide,
an exhaustive guide to creating a logic model.53
http://www.wkkf.org/knowledge-center/resources/2006/02/wk-kellogg-foundation-logic-modeldevelopment-guide.aspx
Data Collection, Analysis and Reporting
Evaluation Publications
This website has several evaluation publications including guides on planning, designing questionnaires,
and conducting focus groups. Developed by the University of Wisconsin-Cooperative Extension.54
http://www.uwex.edu/ces/pdande/evaluation/evaldocs.html
Analyzing, Interpreting and Reporting Basic Research Results
This guide describes basic considerations that should be taken in gathering, interpreting and reporting data.
By Carter McNamara, PhD.55
http://www.managementhelp.org/research/analyze.htm
Data Collection Methods for Evaluation: Document Review
This CDC Evaluation Brief includes information about using existing documents to collect data for program
evaluation.56
http://www.cdc.gov/healthyyouth/evaluation/pdf/brief18.pdf
Collecting Evaluation Data: Direct Observation
The University of Wisconsin Extension published several brief summaries about program evaluation and
methods for evaluation. This link provides sample observation checklist templates, examples of programs
that can be systematically observed, and sample field notes.57
http://learningstore.uwex.edu/assets/pdfs/g3658-5.pdf
Collecting Evaluation Data: Surveys
This document gives reasons to use surveys, survey methods and their respective advantages and
disadvantages, survey planning, and survey implementation..58
http://learningstore.uwex.edu/assets/pdfs/g3658-10.pdf
Collecting Evaluation Data: Questionnaires
This document covers the pros and cons of questionnaire use, provides example questions, a formatting
guide, and a reference list.59
http://learningstore.uwex.edu/assets/pdfs/g3658-2.pdf
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Analyzing Qualitative Data
This guide outlines a basic approach for analyzing and interpreting narrative data (content analysis).60
http://learningstore.uwex.edu/assets/pdfs/g3658-12.pdf
Analyzing Quantitative Data
This guide outlines the basics of understanding descriptive statistics, and highlights how to prioritize
evaluation data.61
http://learningstore.uwex.edu/assets/pdfs/g3658-6.pdf
Partnership Evaluation
Fundamentals of Evaluating Partnerships
Partnership evaluation is useful in improving productivity of state partnerships, guiding partnership
activities, determining whether or not goals and objectives have been met, and promoting the public image
of the partnership, among other benefits. The CDC’s partnership evaluation guide can be accessed at:62
http://www.cdc.gov/dhdsp/programs/nhdsp_program/evaluation_guides/evaluating_partnerships.htm
Partnership Evaluation: Guidebook and Resources
A more extensive guidebook on partnership evaluation specifically geared towards nutrition, physical
activity and obesity can be found at:63
http://www.cdc.gov/obesity/downloads/PartnershipEvaluation.pdf
Evaluation Consultation Groups
Developing and Using an Evaluation Consultation Group
The primary purpose of an Evaluation Consultation Group is to provide input to the state health department
on the best scientific and most practical evaluation activities of the nutrition, physical activity and obesity
partnerships, state policies, and other evaluation activities. They are useful for planning, prioritizing,
designing, implementing, reporting and using evaluation activities. A guide for the formation of
consultation groups can be found at:64
http://www.cdc.gov/obesity/downloads/EvaluationConsultationGroup.pdf
Community Example
Hearts N’ Parks
A program that helps local community, park and recreation agencies promote a heart-healthy lifestyle
and changes. The first link illustrates how results are reported. The second link provides the community
mobilization guide which includes assessment tools used to measure program performance. Developed by
the National Heart, Lung, and Blood Institute and the National Recreation and Park Association.65
http://www.nhlbi.nih.gov/health/prof/heart/obesity/hrt_n_pk/
http://www.nhlbi.nih.gov/health/prof/heart/obesity/hrt_n_pk/cm_perf.pdf
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Selected additional evaluation tools
CDC Evaluation Working Group
CDC’s resource bank for evaluation, provides a thorough discussion of CDC’s framework as well as the steps
to be conducted within the framework. 66
http://www.cdc.gov/eval/
American Evaluation Association
International professional association of evaluators devoted to the application and exploration of program
evaluation, personal education, technology, and other forms of evaluation.67
http://www.eval.org/
RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance)
A systematic framework intended to guide researchers, practitioners, and policy makers to evaluate health
behavior interventions.68
http://www.re-aim.org/
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Step 6:
Write the Plan
Introduction
Now that you have formed a coalition, assessed your community, written objectives, decided on
interventions and created an evaluation plan, it is time to write the physical activity plan. The following
pages contain a template designed to facilitate the writing process by using the information gathered in
steps 1-5 detailed in the separate document titled Physical Activity Plan Toolkit: A Guide to Creating a Physical
Activity Plan for Your Community.
HOW TO USE THIS TEMPLATE
This template can, and should, be altered to meet the needs of your community. The written content as well
as the formatting and design are intended to be modified to reflect your community’s mission and vision.
All of the fill-in-the-blank areas, directions or examples are shown in red font and brackets [ ] in order to
facilitate easier adaptation and to help make it clear that these areas need to be filled in or removed before
the report is published. Furthermore, it is likely that many coalitions will not feel it is within their scope to
address each one of the eight areas targeted by the National Physical Activity Plan; again, coalitions can
broaden or focus their scope of work to meet the needs of their community.
One key point that we would like to stress is to keep your audience in mind while writing the plan. This
should influence the layout, length, and language that your plan employs. The template we have provided
includes the heading “Template”, in order to remind users that the document is meant to be used as such.
The layout that we suggest using for your plan is as follows:
1.
Cover page
2.Acknowledgements
3.
Table of Contents
4.
Mission and Vision
5.
Executive Summary - *write this summary after completing the plan
6.Introduction
7.
Interventions, Objectives and Evaluations
8.
Engaging communities in implementation
9.
References and Resources
10.Appendices
The template is available as a separate Microsoft Office Word document
to allow adaptation and tailoring to the coalition’s needs. See the PAPRN
website to download the template http://paprn.wustl.edu
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Physical Activity Plan Toolkit
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Resources
1. I-Min Lee, Eric J Shiroma, Felipe Lobelo, Pekka Puska, Steven N Blair, Katzmarzyk PT. Effect of physical
inactivity on major non-communicable diseases worldwide: an analysis ofburden of disease and life
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WV%20Physical%20Activity%20Plan_Final.pdf
4. Active Texas 2020: Taking Action to Improve Health by Promoting Physical Activity. https://sph.uth.edu/
content/uploads/2012/06/Active-Texas-2020-full.pdf
5. Eyler A, Chriqui J, Maddock J, et al. Opportunity Meets Planning: An Assessment of the Physical Activity
Emphasis in State Obesity-Related Plans. Journal of Physical Activity & Health. 2012.
6. Cohen L, Baer N, Satterwhite P. 8-step Developing effective coalitions: An eight-step guide.
The Prevention Institute. http://www.preventioninstitute.org/index.php?option=com_
jlibrary&view=article&id=104&Itemid=127
7. Creating and maintaining coalitions and partnerships: Outline with community tool box resources for
creating and maintaining coalitions and partnerships. The Community Tool Box. http://ctb.ku.edu/en/
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8. Communities putting prevention to work. CDC-Foundational Skills. http://www.cdc.gov/
CommunitiesPuttingPreventiontoWork/resources/foundational_skills.htm
9. The Community Tool Box: Proclaiming Your Dream: Developing Vision and Mission Statements. http://
ctb.ku.edu/en/table-of-contents/structure/strategic-planning/vision-mission-statements/main
10.History of the Plan. National Physical Activity Plan. http://www.physicalactivityplan.org/history/index.
php
11.Renault, V. SWOT Analysis: Strengths, Weaknesses, Opportunities, and Threats. The Community Tool Box.
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12.Prevalence and Trends Data. Behavioral Risk Factor Surveillance System. http://apps.nccd.cdc.gov/brfss/
index.asp
13.Adolescent and School Health: Youth Behavioral Risk Factor Surveillance System. Centers for Disease
Control and Prevention. http://www.cdc.gov/healthyyouth/yrbs/index.htm
14.Community Health Needs Assessment (CHNA). Community Commons. http://assessment.
communitycommons.org/CHNA//about.aspx
15.Diabetes Interactive Atlases. Centers for Disease Control and Prevention. http://www.cdc.gov/diabetes/
atlas/countydata/County_EXCELstatelistLTPIA.html
16.American Community Survey. United States Census Bureau. http://www.census.gov/acs/www/library/
17.Arizona Nutrition and Physical Activity State Plan. Arizona Department of Health Services. http://
physicalactivityplan.org/resources/PA-Plans/ArizonaPA.pdf
18.Physical Activity Community Assessment. Champions for Change. http://www.cachampionsforchange.
cdph.ca.gov/en/docs/OurCommunity/HowTo/HandPAAssessment.pdf
19.Complete Streets for North Country Communities Advocacy Kit. North Country Healthy Heart Network,
Inc. http://www.mihealthtools.org/mihc/documents/NorthCountryCommunitiesCompleteStreetsGuide.
pdf
20.Walkability Checklist. http://www.nhtsa.gov/Driving+Safety/Pedestrians/Walkability+Checklist
21.Walk Score. http://www.walkscore.com
22.Bikeability Checklist. http://www.nhtsa.gov/people/injury/pedbimot/bike/bikeability/
23.Physical Activity Plan Development. West Virginia Physical Activity Plan. http://wvphysicalactivity.org/
paprn.wustl.edu
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documents/WV%20Physical%20Activity%20Plan_Final.pdf
24.Duke, H. Active Texas 2020: Taking Action to Promote Physical Activity. Directors for Health Promotion
and Education. https://sph.uth.edu/content/uploads/2012/06/Active-Texas-2020-full.pdf
25.The Plan. National Physical Activity Plan. http://www.physicalactivityplan.org/theplan.php
26.Writing SMART Objectives. Department of Health and Human Resources: Centers for Disease Control and
Prevention. http://www.cdc.gov/healthyyouth/evaluation/pdf/brief3b.pdf
27.Iowa’s Comprehensive Nutrition and Physical Activity Plan. Iowans Fit for Life. http://www.idph.state.
ia.us/iowansfitforlife/common/pdf/activity_plan.pdf
28.Physical Activity, Nutrition, and Obesity Prevention Comprehensive Plan. Delaware Partners to Promote
Healthy Eating and Active Living. http://dhss.delaware.gov/dhss/dph/dpc/files/pano_comp_plan-09.pdf
29.The Ohio Obesity Prevention Plan. Ohio Department of Health. http://www.healthyohioprogram.org/~/
media/HealthyOhio/ASSETS/Files/obesity/ohioobesitypreventionplan.ashx
30.State Program Evaluation Guides: Writing SMART Objectives. Centers for Disease Control and Prevention.
http://www.cdc.gov/dhdsp/programs/nhdsp_program/evaluation_guides/smart_objectives.htm
31.Kentucky Nutrition and Physical Activity State Plan 2005. Partnership for a Fit Kentucky. http://fitky.org/
32.Moving South Carolina Towards a Healthy Weight. South Carolina Department of Health and
Environmental Control, and South Carolina Coalition for Obesity Prevention Efforts. http://www.scdhec.
gov/health/chcdp/obesity/docs/StatePlanComplete.pdf
33.Georgia’s Nutrition & Physical Activity Plan. Georgia Department of Human Resources, and Take Charge
of Your Health, Georgia. http://beproactivefoundation.org/media/6a9a857bc6e14cbdffff8020ffffd523.pdf
34.Writing Measurable Objectives. Victoria Department of Health. http://www.health.vic.gov.au/regions/
southern/downloads/Tip-sheet-writing-measurable-objectives.pdf
35.Guidelines for School and Community Programs to Promote Lifelong Physical Activity Among Young
People. Centers for Disease Control and Prevention. http://www.cdc.gov/mmwr/PDF/rr/rr4606.pdf
36.The Plan. National Physical Activity Plan. http://www.physicalactivityplan.org/theplan.php
37.Increasing Physical Activity. The Community Guide. http://thecommunityguide.org/pa/index.html
38.Columbia, Missouri: New drop-off area creates excitement about walking to school. National Center for
Safe Routes to School. http://www.saferoutesinfo.org/data-central/success-stories/columbia-missourinew-drop-area-creates-excitement-about-walking-school
39.Wheeling Walks. National Cancer Institute. http://rtips.cancer.gov/rtips/programDetails.
do?programId=234167
40.History of SRTS. National Center for Safe Routes to School. http://www.saferoutesinfo.org/about-us/
mission-and-history
41.National Complete Streets Coalition. Smart Growth America. http://www.smartgrowthamerica.org/
complete-streets/complete-streets-fundamentals
42.Request for Policy Implement. State of Delaware Department of Transportation. http://www.deldot.gov/
information/pubs_forms/manuals/complete_streets/o06_complete_streets_policy.pdf
43.Health and Wellness. Safeway Inc. http://csrsite.safeway.com/people/employees/health-wellness/
44.Open Streets Project. Alliance for Biking and Walking, and Street Plans. http://openstreetsproject.org/
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heatwalkingcycling.org
47.Behavioral and Social Approaches to Increase Physical Activity: Individually-Adapted Health Behavior
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individuallyadapted.html
paprn.wustl.edu
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48.Physical Activity Evaluation Handbook. Centers for Disease Control and Prevention. http://www.cdc.gov/
nccdphp/dnpa/physical/handbook/pdf/handbook.pdf
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gov/obesity/downloads/CDC-Evaluation-Workbook-508.pdf
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57.Taylor-Powell E. and Steele, S. Collecting Evaluation Data: Direct Observation. University of WisconsinExtension. http://learningstore.uwex.edu/assets/pdfs/g3658-5.pdf
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http://learningstore.uwex.edu/assets/pdfs/g3658-10.pdf
59.Taylor-Powell E. Questionnaire Design: Asking Questions with a Purpose. University of WisconsinExtension. http://learningstore.uwex.edu/assets/pdfs/g3658-2.pdf
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learningstore.uwex.edu/assets/pdfs/g3658-12.pdf
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uwex.edu/assets/pdfs/g3658-6.pdf
62.State Program Evaluation Guides: Fundamentals of Evaluating Partnerships. Centers for Disease Control
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partnerships.htm
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obesity/downloads/PartnershipEvaluation.pdf
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obesity/hrt_n_pk/
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67.Welcome to the American Evaluation Association. American Evaluation Association. http://www.eval.org/
68.Reach Effectiveness Adoption Implementation Maintenance (RE-AIM). Virginia Polytechnic Institute and
State University. http://www.re-aim.org
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